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<br />
<br />CONFLICT OF INTEREST
<br />
<br />City of Sunny Isles Beach
<br />18070 Collins Avenue
<br />Sunny Isles Beach, FL 33160
<br />Telephone: (305) 947-0606 Fax: (305) 949-3113
<br />
<br />Or su'"
<br />
<br />CONFLICT OF INTEREST STATEMENT
<br />
<br />The award of any contract hereunder is subject to the provisions of Chapter 112, Florida State Statutes. Proposers must
<br />disclose with their Bids, the name of any officer, director, partner, associate or agent who is also an officer or employee of the
<br />City of Sunny Isles Beach or its agencies.
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF Broward
<br />
<br />BEFORE ME, the undersigned authority, personally appeared Dennis J. Giordano
<br />deposes, and states:
<br />
<br />, who was duly sworn,
<br />
<br />18.1. I am the President
<br />Calvin, Giordano & Associates, Ino..vith a local office in I-ort Lauderdale
<br />Fort Lauderdale
<br />
<br />of
<br />and principal office in
<br />
<br />18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. 11-07-01 described
<br />as: Special Inspection ServiceE, The Affiant has made diligent inquiry and provides the information contained in this
<br />Affidavit based upon his own knowledge,
<br />
<br />18.3 The Affiant states that only one submittal for the above Bid is being submitted and that the above named entity has
<br />no financial interest in other entities submitting Bids for the same project.
<br />
<br />18.4 Neither the Affiant nor the above named entity has directly or indirectly entered into any agreement, participated in
<br />any collusion, or otherwise taken any action in restraints of free competitive pricing in connection with the entity's submittal for
<br />the above Bid. This statement restricts the discussion of pricing data until the completion of negotiations if necessary and
<br />execution of the Contract for this project.
<br />
<br />18.5 Neither the entity nor its affiliates, nor anyone associated with them, is presently suspended or otherwise ineligible from
<br />participation in contract letting by any local, State, or Federal Agency.
<br />
<br />18.6 Neither the entity, nor its affiliates, nor anyone associated with them have any potential conflict of interest due to any
<br />other clients, contracts, or property interests for this project.
<br />
<br />18.71 certify that no member of the entity's ownership or management is presently applying for any employee position or
<br />actively seeking an elected position with the City of Sunny Isles Beach.
<br />
<br />18.81 certify that no member of the entity's ownership or management, or staff has a vested interest in any aspect of the City
<br />of Sunny Isles Beach,
<br />
<br />18.9 In the event that a conflict of interest is identified in the provision of services, I, on behalf of the above named entity, will
<br />immediately notify the City of Sunny Isles Beach.
<br />
<br />Dated th' \ day of ~J /~ "- Q -^-.\ _ , 201k\
<br />~ '\Q' rY1\"-'.. h 1.'yrhn1", {_Jvp (, Ir\ (\ rd
<br />AFFIA Print or Type Name and Title
<br />
<br />" S"worn to and subscribed before me this ~ day of '--- \.\.. J, ~ _lJ , 201 V
<br />E'-. Personally Known OR '
<br />o Produced Ideo,mcatloo ; Type otifi'~t1ficatiOO
<br />
<br />J;J i I N
<br />I ~~ .
<br />
<br />
<br />NOTARY PUBLIC STATE OF FLORIDA
<br />
<br />I
<br />
<br />C/-kJOIu' jjJ
<br />
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<br />
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<br />"""11,,
<br />~'m'\Io!!Y "~''\o DAWN HOPKINS
<br />.:"" fi'lo
<br />f. * : . E Notary Public . State of Florida
<br />;",..~g My Comm. Expires Feb 18,2013
<br />','f}: ct;'--~
<br />",f"?r.~.~"",, Commission 1# DD 862678 ~
<br />
<br />DECEMBER ,ZUlU" ..... 5 of 7
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